1. Field of the Invention
This invention relates to endoscopic surgical instruments having flush ports. More particularly, the invention relates to a surgical tool with at least one articulated member, a handle with actuating means for movement of the articulated member, a hollow elongated shaft connecting the tool and handle and having a hole in the shaft for flushing the shaft, and an actuating rod connecting the actuating means and articulated member such that the rod is slidably disposed within the lumen of the shaft. Specifically, the present invention relates to a means for affixing a removable collar to the shaft of the instrument whereby the affixing means can also function as a flush port for flushing the shaft via the hole in the shaft.
2. Background Art
Endoscopic surgical procedures are rapidly replacing conventional surgical techniques in a variety of applications. Diagnostic or therapeutic endoscopy procedures are generally preferred because they reduce trauma, decrease the risk of infection at incision sites, and increase patient recovery times. Arthroscopy procedures, for example, have all but replaced arthrotomy approaches for joint repair. Likewise, laparoscopic surgery is rapidly becoming the method of choice for a variety of abdominal procedures that once required large laparotomy incisions.
The laparoscope allows the surgeon to perform surgery within the abdomen by providing visualization of an internalized surgical field. The laparoscope and related instruments are usually introduced into the abdomen through a self-sealing cannula introduced into the abdomen via a small incision or trocharized opening in the abdominal wall. These small openings are generally sealed around the cannula during the procedure, thereby preventing airborne contamination of the surgical field and escape of insuffiation gases. After surgery, the incision sites are easily closed and usually heal quickly with minimal scarring.
The growing popularity of laparoscopic surgery and the continuing development of new laparoscopic surgical techniques has created a need for specialized surgical instruments. As a result, many surgical instruments have been designed to meet the special needs of the laparoscopic surgeon. Most of these instruments, by necessity, contain certain basic design similarities. For example, in instruments which are comprised of a tool with an articulated member which must be actuated by means located on the handle, the handle is usually connected to the surgical tool via an elongated hollow shaft which contains an actuating rod connecting the tool and actuating means. This elongated shaft design allows the surgical tool to be introduced into the abdomen through the cannula while allowing the surgeon to operate the tool via the actuating means on the handle from a point external of the abdomen. Examples of such instruments include various retractors, hemostats, tissue clamps, needle holders, and the like.
A major problem with laparoscopic instruments having the hollow shaft design is that the lumen of the shaft acts as a reservoir for surgical debris and contaminants. Tissue fragments, blood and other body fluids can become trapped in the lumen and serve as a nidus for bacterial growth and a means for transferring disease from patient to patient.
As a result, instruments were developed with a proximally located flush port or tube on the shaft which allows for irrigation and flushing the lumen of the shaft to remove tissue debris and contaminants. The tubes currently in use are usually constructed of plastic or metal and are firmly attached to the shaft with a glue, weld, or other sealant, or they are molded into the shaft at manufacture. Therefore, these ports cannot be removed or replaced if damaged. Likewise, the surgeon is limited to attaching a flush source which has end connectors that are complimentary to those of the flush port.
A second design problem arose out of the surgeon's need to change the orientation of the tool with respect to the handle during surgery and resulted in instruments designed with rotatable shafts. In these instruments, a collar is permanently attached around the shaft acting as a knob for rotating the shaft about the long axis of the instrument. The collar of currently available instruments cannot be easily removed for cleaning or replaced with a collar of a different configuration.
Therefore, there still exists a need in the art for an instrument with a flush port or tube which is easily removable if damaged or to change the configuration of the tube connector by the surgeon if desired. There also exists a need for an instrument which has a collar which is easily removable for cleaning or for a change in configuration.
The present invention satisfies these needs by providing an instrument which has a removable flush port and a removable collar. Moreover, the present invention incorporates the means for removably affixing the collar to the shaft into the design of a removable flush port. The removable flush port, which simultaneously affixes the collar, saves time during instrument assembly and repair, allows for removal of the collar for thorough cleaning or repair, and allows the surgeon flexibility to change configuration of the collar or flush connector.